Allegheny County has spent millions in opioid settlement money it has received so far on everything from overdose reversal drugs for first responders to child care and housing for people in recovery, according to records obtained by WESA.
The spending was outlined in a report the county filed with the Pennsylvania Opioid Misuse and Abatement Trust, the statewide entity overseeing opioid settlement spending by Pennsylvania counties. The report covers spending in 2022 and 2023; roughly $14.4 million was received by the county during that time and about half of it was spent or allocated. Funding so far has gone to support a mix of existing human services programs, as well as new services and supports.
County officials “have pretty high standards for how this money should be utilized and the processes that should go into how the money gets spent,” said Stuart Fisk, director of the office of behavioral health at the Allegheny County Department of Human Services. “And I feel that we're doing a very good job. I really do.”
WESA obtained the 45-page report through a Right to Know request filed as part of ongoing reporting with Spotlight PA focused on opioid settlement spending statewide. The news organizations have requested spending reports from all 67 counties and 10 district attorneys’ offices that have received funds. The news organizations have publicly shared the reports they have received so far.
Allegheny County has been publicly posting information about broad categories of expenditures, though the report represents a comprehensive snapshot of the county’s spending of the funds in 2022 and 2023, and includes more detailed information about the specific programs and organizations that received funds.
The county is projected to receive at least $90 million over 18 years from various opioid settlements with companies that manufactured and distributed the addictive painkillers. All county spending must be guided by Exhibit E, a 15-page legal document that broadly outlines acceptable uses for the funds, such as drug treatment and prevention.
For county officials, an important component of choosing what to fund is long-term sustainability, said Erin Dalton, director of Allegheny County’s Department of Human Services. Settlement fund payouts are higher in early years, then are projected to taper off to about $4.2 million annually in later years.
“We can't just kind of innovate these things and then have them go away,” Fisk said.
Officials said they are exploring long-term funding through local health systems and insurers, the state’s Medicaid program, and federal grants, depending on the program.
Housing has been a major use for the dollars locally. More than $595,000 in settlement funds are supporting a low-barrier homeless shelter (though it isn’t clear from documents which shelter) and $181,000 went to purchase recovery housing in Brookline (though the funding to operate the housing comes from other sources).
“Stable housing is important for people in early recovery — or at any point in their life,” Fisk said.
John Ryan’s House, the recovery house, is home for a few months to 20 men in early recovery, said Abbie Scanio, vice president of Jade Wellness Center. Men in the home are in early recovery — a time when people have a high potential for relapse, she said.
“So it's just amazing that we could use these funds to kind of protect them in a way and give them support. And …our goal is to prevent relapse and return them to the community. So, I mean, when we're talking about using the funds for something positive, I really can't think of anything more positive than that,” Scanio said.
More than $452,000 in funds are also being used to provide childcare through Early Head Start for kids whose caregivers have opioid use disorder and are undergoing treatment or job searching.
More than $1.7 million is being used toward a “contingency management” pilot program through Boston-based DynamiCare Health. The pilot “includes the distribution of small financial incentives to enrolled participants for drug treatment adherence that reinforces positive behaviors, such as abstinence, staying current on medications, and completing scheduled therapy,” according to a description filed to the Trust.
The idea is to transition “the patient’s brain reward center from instant gratification for drugs to instant gratification for …healthy behaviors,” said David Gastfriend, DynamiCare’s co-founder and chief medical officer.
“There's really good … brain science behind this, of stimulating reward centers in the brain with these types of incentives,” Fisk said. “It's not just kind of, you know, ‘I'm going to do this because I want to get some dollars.’”
Dalton said perhaps as many as 600 to 700 people will participate in the pilot program.
Also among the county’s reported spending for the last two years: the overdose-reversal drug naloxone for first responders; a student-assistance plan serving children at risk for substance use in all 43 Allegheny County school districts; telehealth clinic services to allow the prescribing of medication to treat opioid use disorder through telemedicine; mobile medication assisted treatment through four mobile vans; medication assisted treatment at the Allegheny County Jail; funding for the River clinic which aids people transitioning from incarceration; emergency department outreach to help patients access evidence-based treatment; funding for a syringe services program; and a public education campaign through advertising.
Separately, last month, county human service officials announced nearly $1 million in funds to seven local groups providing treatment and other supports for opioid use disorder. The funds come from opioid settlement dollars but were not included in the period of time covered in this report.
Allegheny County recorded 661 overdose deaths last year, according to preliminary data, down from a high of 835 in 2017.
Reporter Ed Mahon of Spotlight PA contributed to this report.
